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Syria: Medicine used as a weapon of persecution

While MSF cannot work directly in Syria, it has collected testimonies from wounded patients treated outside the country and from doctors inside Syria. The testimonies, collected from several people from various parts of the country, point to a crackdown on the provision of urgent medical care for people wounded in the ongoing violence in Syria.

"In Syria today, wounded patients and doctors are pursued and risk torture and arrest at the hands of the security services," said Marie-Pierre Allié, president of MSF France. "Medicine is being used as a weapon of persecution."

Most of the wounded do not go to public hospitals, for fear of being tortured or arrested. When a wounded person is admitted to a hospital, a false name is sometimes used to hide his or her identity. Doctors sometimes provide a false diagnosis to help patients elude security forces, which search for patients with wounds consistent with those sustained in protests and demonstrations.

"It is critical that the Syrian authorities reestablish the neutrality of healthcare facilities," said Marie-Pierre Allié. "Hospitals must be protected areas, where wounded patients are treated without discrimination and are safe from abuse and torture, and where medical workers do not risk their lives by choosing to comply with their professional code of ethics."

The injured are largely treated in clandestine treatment facilities by doctors trying to fulfill their commitment and duty to provide medical assistance. Improvised health clinics have been established in apartments, on farms, and elsewhere. Simple rooms outfitted as makeshift operating theaters, known as "mobile hospitals," are used for surgical procedures. Hygiene and sterilization conditions are rudimentary and anesthesia is in short supply. Furthermore, the mere possession of drugs and basic medical materials, such as gauze, is considered a crime.

"The security services attack and destroy the mobile hospitals," said a doctor who requested anonymity. "They enter houses looking for drugs and medical supplies."

Security is the key concern for doctors working in the parallel underground networks. In the prevailing climate of terror, treatment must be provided rapidly since medical workers and patients must constantly change location to avoid detection.

"We are constantly being pursued by the security forces," said another physician. "Many doctors who treated wounded patients in their private hospitals have been arrested and tortured."

It is extremely difficult to treat major trauma cases and provide post-operative care. Furthermore, the clandestine health workers cannot obtain blood from the central blood bank, which is controlled by Syria’s Ministry of Defense – the only blood supplier in the country.

Only a few wounded patients have managed to find refuge in neighboring countries, where they can receive proper—albeit delayed—medical care.

"I was wounded in the thigh and the soldiers caught me,” recounted a patient treated by MSF. “They beat me on the head and on my wound, but I managed to get away with help from people in the neighborhood. In the end, I found someone who could treat me – a nurse, not a doctor. He didn't even have anesthetic."

Under the current circumstances, MSF’s assistance to Syrians requiring medical care is limited. For months, MSF has been seeking official authorization to aid the wounded in Syria, so far without success. The organisation is treating patients outside Syria and is supporting doctors' networks inside the country, through the provision of medicine, medical supplies, and surgical and transfusion kits.